Getting Back to Working Out After Hypothalamic Amenorrhea

Your hypothalamic amenorrhea story isn't over the minute you get your period back. There's still work to do because now you have to keep your ovulation and period. If you want to start working out again – and most of us do – then finding the right amount of exercise is one of the most important pieces of the puzzle. So, how do you do that right? 

Something that I see a lot is that once women get their periods back after not having them for years, they want to instantly get back to their old workout routines and think that everything will be okay. But unfortunately it doesn’t usually work that way.

Say that someone had a goal of losing 20 lbs, and the day she achieved it, she stuffed her face with pizza and ice cream…  She does it a few more times and the yo-yo dieting spiral has started again.

I don't want you to yo-yo your recovery. I don't want you to have to start over again, so do yourself a favor and don't start intense exercise too soon!

What You Should Know About Getting Back to Working Out Again

According to No Period, Now What?, it's a good idea to wait at least three cycles before introducing any high intensity exercise again. That way, you give your body time to really settle. This is the time to message your body: Everything is good, I will give you enough food constantly and keep the stress level low.

After three or so months, as you start working out more, check constantly how your body responds. If your luteal phase (the time from your ovulation to your period) shortens and becomes less than 10 days long and/or your cycle gets very long again or disappears altogether, you may have worked out little too much. Listen to your body and cut back!!

How I Started Working Out Again…

I've gotten a few questions on Instagram about how I got back to exercise. So, the following is my personal story and yours may be different, but I hope you can learn something from mine.

My way back to working out has by no means been easy. Figuring out the right kind, intensity and amount of exercise has been a trial and error, and I even had a few injuries along the way.

The First Month Post Recovery

I started working out again soon after my first cycle, but I didn't jump into high intensity exercise.

During my recovery from December 2016 to May 2017, I had only done yoga 2x/ week and walked every day. I had really started to miss lifting weights, but interestingly, I didn't miss HIIT workouts. In the past, I would have pushed myself to do HIIT anyway — hey, that burns the most calories, right?, but I was finally so much more in tune with my body and decided to do what it asked, which was slower workouts with lots of breaks.

So, when I started exercising again after five months long break, I started working out once a week, lifting weights. I usually picked two to three heavy lifts, like barbell deadlifts, squats, shoulder presses or similar, or dumbbell lunges, shoulder presses, squat presses etc. I would do 8-10 reps of 3-4 rounds with moderate weight (although as I later learned, I should have used lighter weights…). I also mixed in some bodyweight exercises.

I had actually lost a lot of strength.. I could not do chin ups anymore and I was tired after 5 push ups…

Period-wise, things went quite well. My second cycle was on the longer side, but that's what's expected during the first few cycles, so I didn't worry much (and my period did show up).

The Second Month Post Recovery

During the second month or so, added in second similar workout per week. I started getting some knee pain which I couldn't explain… We'll get to that in a minute.

But I started doing a little bit more during that second month. I would sometimes finish my workouts with a short metcon. I remember running a few times for 20 minutes. In addition, I thought I would try to do one higher intensity workout to see how it goes.

And then, I took ONE tough bootcamp class.

Well, that was a mistake…

It was freaking hard.

I literally couldn’t recover from this one 60-minute workout for days. It took me four days to feel like a human again. During these four days, all I did was walking. And sure enough, my cycle ended up being super long. It was probably a combination of doing two lifting sessions, occasional metcon and now this bootcamp class.

My cycle that month was a long one. I also started to lose my sleep again, which was a huge disappointment for me. As a previous insomniac who had just recently found her sleep again (thanks to balancing my hormones, yay!), I did not want that to lose it again.

Rather Less than More Still Works

After this experience, I was determined to slow down again. I took a complete break for about 2 weeks and it worked like magic. My sleep came back and my ovulation came soon after. Everything normalized.

Then we went to Europe for almost a month. I was super relaxed there, didn't worry about my work, even took a break from social media… I moved my body a lot but worked out maybe just 6 times during that time. And for the first time – I think possibly even in my entire life – I had a textbook-perfect , 28-day cycle.

The next cycle was a bit messed up again, but I'm sure that the reason was traveling multiple times through different time zones. It's not uncommon even for healthy women that they miss a period when they're traveling a lot.

My Workouts Now: What Works for Me

After the first few cycles and couple of mistakes, I have now come to understand what works for me best right now (and it may very well change later): lots of very relaxed walking, occasional yoga (usually 1x/ week) and weight training no more than 2x/ week.

When it comes to my strength workouts, I do a quite long warm up to get my muscles prepared. That includes some dynamic stretches, banded walks, glute bridges, specific core and knee work. Then I pick usually three big moves (deadlifts, squats, lunges, some form of pushes and presses, kettlebell carries or other big moves) and do 3-4 rounds of them. I take breaks, so it's nothing like HIIT. I don't generally spend more than 40 minutes in the gym.

Right now, training this way seems to work for my body so that my cycle is normal, my sleep and digestion are great and I have good energy.

Getting Injured: Lifting Too Much Too Quickly

I have had a few injuries along the way as well… I overcame one but I'm still dealing with the other one. Both of them are/were caused by starting to lift too heavy weights little too quickly. Here's what happened:

About a month into working out again, I started getting some quite intense knee pain. It scared me, because it was really strong. I even thought that it’s my decreasing bone density manifesting! Quite honestly, I was freaking out. The knee pain got so intense that I couldn’t squat anymore, even without weights. Just sitting down in the bathroom was painful. Needless to say, I had to take a break from squatting at the gym so I did other things that I could.

I talked to my friend who is a physical therapist and I also took a workshop by dr Scott Mills (the workshop was about back pain, but we talked a little about other areas of the body too, because they’re all related!). My friend suggested that I may have started training with weights that were too heavy for me after such a long break. She gave me a few special exercises to strengthen my adductors and abductors (inner and outer thighs) which are important in stabilizing the knee, and I learned a few other exercises at dr Mills' workshop. I was super consistent with doing my knee exercises at least 5x a week (they are very low intensity exercises that take about 10-15 minutes) and my pain went away in about 6 weeks.

However, a few months back, my back started to feel uncomfortable when I was lifting weights. After a while, the pain got very intense, even when I wasn't exercising. The problem might be that my core muscles may have lost some strength also, just like had happened to my knee stabilizers. I'm still trying to figure this thing out though, because some days, my back feels incredibly tight and even just moving around can be painful.

When you're just starting working out again too, make sure to keep your weights moderate. You may even have to go back and focus specifically on smaller muscle groups and take time to strengthen them. I am working on my core and knee stabilizing muscles every workout as a part of my warm up.

Conclusion

Don't rush! I know you may have missed working out, but if you were able to stay away from training for several months to recover, you can take it easier for another month. It's NOT a good idea to start working out 5x/ week again. Losing your period again, then stressing about it, and maybe even getting injured, aren't worth it.

I suggest you don't do more than 2 workouts a week when you're just getting back to it. In addition, you can still walk and find other lighter ways to stay active. Jumping back into bootcamp, crossfit or long runs is almost definitely not good for your hormones. Remember that you found your hormonal balance just recently, so your main goal is to keep it.

The better job you can do in gradually increasing intensity and duration of your workouts, the better it's going to be for your body!

Do you have hypothalamic amenorrhea? Learn how to eat to recover from it. 

Have you recovered hypothalamic amenorrhea and want to start training again? My program Simple Strength for Women helps you to do it safely, without you losing your period again!